Mary Agnes Mantilla in Poughkeepsie - Clinical
Mary Agnes Mantilla - NPI 1609868439
Mary Agnes Mantilla is a Clinical in Poughkeepsie, New York. Mary Agnes Mantilla practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Agnes Mantilla is 1609868439. The last update date is 2017-03-30.
Mary Agnes Mantilla's current location address is 3 Neptune Rd Ste A18f, Poughkeepsie, New York. You can contact this provider via phone number 8455498223. The mailing address for Mary Agnes Mantilla is 3 Neptune Rd Ste A18f, Poughkeepsie, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Agnes Mantilla |
|---|---|
| Address | 3 Neptune Rd Ste A18f, Poughkeepsie, New York |
| Phone Number | 8455498223 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1609868439 |
|---|---|
| Provider Enumeration Date | 2005-08-18 |
| Last Updated Date | 2017-03-30 |
Provider Mailing Address Detail
| Address | 3 Neptune Rd Ste A18f |
|---|---|
| City | Poughkeepsie |
| State | New York (NY) |
| Post Code | 126015500 |
| Phone Number | 8455498223 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 068980-1 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 068980-1 | NY | LMSW LICENSE |
Post Comment/ Review Below
What is the unique identifier code issued to Mary Agnes Mantilla by the Centers for Medicare & Medicaid Services (CMS)?
The Mary Agnes Mantilla has been assigned the NPI (National Provider Identifier) 1609868439. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Mary Agnes Mantilla is located?
The Mary Agnes Mantilla is situated at the following address: 3 Neptune Rd Ste A18F, Poughkeepsie, NY, 126015500.
What is Mary Agnes Mantilla's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Agnes Mantilla's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
When did the Mary Agnes Mantilla receive its 1609868439?
The Mary Agnes Mantilla was issued its 1609868439 on 2005-08-18, which is the date when the organization was assigned this unique identifier.
As of what date were the details related to Mary Agnes Mantilla most recently updated or revised?
The information pertaining to Mary Agnes Mantilla, including its address, specialty, and other relevant details, was last updated or revised on 2017-03-30.